Nasopharyngeal carcinomas are nonglandular carcinomas that arise in the nasopharynx. Nasopharyngeal carcinomas are very common in the Orient. Initial complaints are often due to middle-ear obstruction (otitis, hearing loss) or local invasion (headache, cranial nerve deficits). At least half of the patients with undifferentiated nasopharyngeal carcinoma are seen with cervical lymph node metastasis from an occult primary. The nasopharyngeal carcinomas are subtyped as keratinizing squamous cell carcinoma, nonkeratinizing carcinoma and undifferentiated carcinoma. Squamous cell carcinoma and nonkeratinizing carcinoma mainly develop in adults and are rare in childhood. In contrast, undifferentiated carcinoma often occurs in children and shows a bimodal age distribution, with peaks in the second and sixth decades. All forms of nasopharyngeal carcinoma occur more frequently in males. Nasopharyngeal carcinoma is treated with radiation. Keratinizing squamous carcinomas are least radiation sensitive and have the poorest prognosis. Nonkeratinizing carcinomas have a survival rate intermediate between keratinizing and undifferentiated carcinomas or they behave like undifferentiated carcinomas. In several large series of cases treated with radiation, undifferentiated carcinoma had the following 5-year survival rates, according to stage: stage I: 50% to 60%; stage II: 20% to 30%; and stage III:5% to 20% (Sternberg's Diagnostic Surgical Pathology, 3rd ed., 1999). --2002